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Rise in Rate of Throat Cancer Linked to HPV

Article date:
October 26, 2011

By Stacy Simon

A type of throat cancer linked to the human papilloma virus (HPV) is rising dramatically, according to researchers at the National Cancer Institute and Ohio State University. At this rate, they say HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) will likely surpass cervical cancer by 2020 as the most common HPV-associated cancer in the United States.

Oropharyngeal cancer develops in the part of the throat just behind the mouth and is sometimes simply called throat cancer. It includes cancers of the back third of the tongue, the back part of the roof of the mouth, the tonsils, and the side and back wall of the throat. The most common symptoms of oropharyngeal cancer are a sore in the mouth that does not heal or mouth pain that doesn’t go away. Historically, this type of cancer has been strongly linked with tobacco and alcohol use, but in recent years some of these cancers have been linked to HPV infection.

For this study, researchers tested oropharyngeal cancer tissue samples collected from 3 national cancer registries between 1984 and 2004. They found that the number of people with HPV-positive OPSCC more than tripled over this period. But at the same time, the number of those with HPV-negative OPSCC fell by 50%. As a result, more than 70% of these cancers were HPV-positive by the end of the study period.

The drop in HPV-negative OPSCC was expected because cigarette smoking in the U.S. is declining, but the rapid rise in HPV-positive cancers has more than offset this, leading to an overall increase in oropharyngeal cancer rates.

The reason for the rapid rise in HPV-positive OPSCC is not totally clear, but it is likely related to changes in sexual behavior in recent decades, including oral sex becoming more common. HPV-positive OPSCC is most often diagnosed at a younger age than HPV-negative OPSCC and is more common in men.

The study findings could have major implications for the treatment – and possibly the prevention – of this type of cancer in the future.

The researchers note that long-term survival rates tend to be better for HPV-positive OPSCC, and that these cancers seem to have benefited more than HPV-negative cancers from treatment advances in recent years. Doctors are now trying to determine if these two types of OPSCC might need to be treated differently.

Perhaps a larger implication of the findings is that many of these HPV-positive cancers might be prevented in the future. Vaccines are currently available that protect against 2 types of HPV that cause most cervical cancers, as well as some other genital area cancers. The same types of HPV are found in some oropharyngeal cancers, but it is not yet known if the vaccine is helpful in protecting against these cancers.